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General NPI Number Information
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NPI Number | 1336837061
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Entity Type | Organization
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Legal Business Name | ALIVE FAMILY PSYCHIATRY
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Dates
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Enumeration Date | 05/01/2023
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 3515 S 4TH ST STE 102
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City | LEAVENWORTH
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State | KS
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Zip | 66048-5079
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Country | US
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Telephone | 816-845-8550
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Fax | 949-440-7590
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Provider Business Mailing Address
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Address Line | 3515 S 4TH ST STE 102
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City | LEAVENWORTH
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State | KS
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Zip | 66048-5079
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Country | US
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Telephone | 816-845-8550
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | JULIA FIELDS
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Credential | APRN
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Telephone | 816-845-8550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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